Metabolic and Immunoinflammatory Profiles in Adults With Newly Diagnosed Diabetes

Adult-onset diabetes is increasingly recognized as a heterogeneous condition with diverse underlying pathophysiological mechanisms. At the time of diagnosis, individuals may present with varying degrees of insulin resistance, impaired beta-cell function, and immune activation. However, traditional classifications based mainly on glycemic parameters do not fully capture this complexity.

This study aims to provide an integrated assessment of metabolic and immunoinflammatory features in adults with newly diagnosed diabetes. Particular attention is given to the interplay between insulin resistance, beta-cell function, and immune-mediated processes, including islet autoimmunity and inflammatory signaling pathways.

The study focuses on key metabolic indicators such as body mass index, glycemic control, C-peptide levels, and indices derived from the HOMA2 model, as well as immunological markers including islet autoantibodies and cytokines involved in the interleukin-1 pathway. The balance between pro-inflammatory and anti-inflammatory activity is assessed through the IL-1β/IL-1Ra ratio.

By integrating metabolic and immunological data, this study seeks to better characterize early-stage heterogeneity of adult-onset diabetes and to contribute to improved phenotypic classification. A more comprehensive understanding of these mechanisms may support the development of more personalized approaches to diagnosis and disease management in diverse populations.

Inclusion criteria

• Adults aged 25 years and older
• Kazakh population with newly diagnosed diabetes mellitus
• Diagnosis established in routine clinical practice
• No prior insulin therapy at the time of enrollment
• No prior use of glucose-lowering therapy beyond initial management
• Ability and willingness to provide informed consent

Exclusion criteria

• Clinical features suggestive of classical type 1 diabetes at presentation
• History of long-term insulin therapy prior to enrollment
• Severe acute illness or infection at the time of assessment
• Pregnancy
• Incomplete clinical or laboratory data